New Delhi: Recently, a social media post, which has now gone viral, explained a simple and an easy way to improve oxygen levels. The post has garnered huge attention because at a time, when the COVID-19 cases are rapidly increasing, people are taking adequate precautions, including constant monitoring of oxygen levels in the body, to help prevent the further spread of the deadly disease.Also Read - Covid-19: Centre Extends Insurance Scheme for Health Workers for Another 180 Days
Largely, most healthy people get a reading of 95 and above, but any significant drop should be immediately brought to the consulting physician’s attention to seek immediate medical help before the infected person reaches the critical stage of acute respiratory disease syndrome (ARDS). Patients presenting with ARDS need mechanical ventilation, as their lungs are unable to oxygenate blood on their own due to fluid accumulation. Also Read - Present Evidence Does Not Suggest That it is 'XE' Variant of Covid19, Say Reports
One of the Twitter users had shared a video of a person explaining a simple way to “improve” oxygen levels to above 95, and also demonstrated it using a pulse oximeter. Also Read - Covid-19 Can Increase the Risk of Heart Disease in the Future? Yes it can- Know How
Check out the video here
In the video, the man can be heard saying that while in the sitting position the oximeter read 95 and below, in the prone or on the stomach position with pronal breathing (also called ventilator breathing), the oxygen levels are seen to steadily increase to 98 from 93-94 within a minute.
Does lying on the belly in the prone position, as mentioned in the video, actually improve oxygen levels?
As new a concept as it may be for many of you, but this technique has been in practice since ages. Lying on the chest and stomach position, or on the sides, is considered to help the body get air into all areas of the lungs rather than lying flat on the back, according to experts. Called the proning position, the technique has proven to be an effective measure for a long time in the treatment of patients with acute respiratory disease syndrome (ARDS). According to a study published in the European Respiratory Journal, 2002, this is considered “a simple and safe method to improve oxygenation.”
What does the study say?
According to the study, the main physiological aim of prone positioning are to improve oxygenation; to improve respiratory mechanics; to homogenise the pleural pressure gradient, the alveolar inflation and the ventilation distribution; to increase lung volume and reduce the amount of atelectatic regions; to facilitate the drainage of secretions; and to reduce ventilator-associated lung injury. In fact, the study also concluded that oxygenation improves in 70 to 80 per cent of patients with early acute respiratory distress syndrome.
The experts’ take
As per a National Center for Biotechnology Information (NCBI) study ‘Awake Proning: A Necessary Evil During the COVID-19 Pandemic’ published in Cureus Journal in July 2020, “Awake proning delays the use of mechanical ventilation and facilitates the patients with severe ARDS or severe pneumonia in maintaining the supply of oxygen to the body tissues. Since medical institutes are overburdened and limited ventilators are available, awake proning can reduce not only the burden on hospitals but also decrease the need for ventilators.”
Meanwhile Indian Express quoted Dr Praveen Gupta, director and head of department, neurology, Fortis Memorial Research Institute, Gurugram, “This position helps in improving oxygen flow in patients who are critical, in turn ensuring that they are less likely to require ventilator support.”
Besides, a study conducted in New York regarding the self-proning found it to be effective. The study was based on the quick proning of patients that presented with moderate to severe ARDS after getting infected with coronavirus. The patients were put into the prone positions for about 18 hours a day while the breathing cycles started showing improvements after five minutes of assuming the position of awake proning.
As per the findings published in the journal Accident Emergency Medicine in May 2020, 50 patients with confirmed hypoxia were under focus for this study and their median saturation of oxygen in blood was 80 per cent, which was raised to 84 per cent after the provision of supplemental oxygen. After five minutes of lying in the prone position, the levels of oxygen saturation were raised to 94 per cent, and the patients were also put on supplemental oxygen. In this study, intubation was not needed in nearly two-thirds of the admitted patients.
(Image source: Pixabay)
Things to keep in mind
However, please note that as per the NCBI study, this proning method isn’t for every0ne affected with the coronavirus. The contraindications include: a history with spinal instability like spondylolisthesis, scoliosis, injury, or trauma to the spine; increased intracranial pressure; pregnancy; hemodynamically unstable conditions like hypertension and cardiopulmonary diseases; and abdominal open wounds among others.
“It is recommended that patients suffering from ARDS be advised to acquire a prone position while they are conscious but while falling asleep, a neutral position should be advised,” mentioned the 2020 study.
Also, please check out the Ministry of Health and Family Welfare’s guide to proning for self care. Check it out here.